Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jun 17;8(6):868.
doi: 10.3390/jcm8060868.

A Systematic Review of NAFLD-Associated Extrahepatic Disorders in Youths

Lucia Pacifico  1 , Francesco Massimo Perla  2 , Mario Roggini  3 , Gianmarco Andreoli  4 , Miriam D'Avanzo  5 , Claudio Chiesa  6
Affiliations
Review

A Systematic Review of NAFLD-Associated Extrahepatic Disorders in Youths

Lucia Pacifico et al. J Clin Med. .

Abstract

Background: There is growing evidence that non-alcoholic fatty liver disease (NAFLD) is a disease affecting not only the liver but also extrahepatic organs.

Aim: To investigate whether in youths NAFLD is associated with extrahepatic complications such as subclinical atherosclerosis, cardiac abnormalities, hypertension, type 2 diabetes, decreased bone mineral density, renal dysfunction, obstructive sleep apnea, and polycystic ovary syndrome.

Methods: We systematically reviewed PubMed; Scopus; Embase; and the Cochrane Library databases up to 28 February 2019 and assessed the quality of studies using the Newcastle-Ottawa Scale.

Results: Thirty-five articles were selected for this systematic review: fifteen (4627 participants) evaluated the association of NAFLD with subclinical atherosclerosis; four (969 participants) with cardiac abnormalities; two (550 participants) with hypertension; four (1328 participants) with diabetes; six (523 participants) with low bone mineral density; two (865 participants) with renal dysfunction; one with obstructive sleep apnea; and one with polycystic ovary syndrome. Most studies found that youths with NAFLD have increased features of subclinical atherosclerosis; as well as of cardiac alterations. Limited data were available to endorse a solid estimate of the prevalence of diabetes; low mineral density and renal dysfunction in the pediatric NAFLD population.

Conclusion: NAFLD-related intermediate CVD outcomes can occur and be detected early in young populations.

Keywords: NAFLD; cardiac structural and functional abnormalities; children and adolescents; decreased bone mineral density; hypertension; obstructive sleep apnea; polycystic ovary syndrome; renal dysfunction; subclinical atherosclerosis; type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Extra-hepatic organ damage in youths with NAFLD.
Figure 2
Figure 2
Flow diagram of the study selection process.
See this image and copyright information in PMC

References

    1. Nogrady B. Childhood obesity: A growing concern. Nature. 2017;23:551. doi: 10.1038/d41586-017-05868-y. - DOI - PubMed
    1. Rinella M.E. Nonalcoholic fatty liver disease: A systematic review. J. Am. Med. Assoc. 2015;313:2263–2273. doi: 10.1001/jama.2015.5370. - DOI - PubMed
    1. Targher G., Day C.P., Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N. Engl. J. Med. 2010;363:1341–1350. doi: 10.1056/NEJMra0912063. - DOI - PubMed
    1. Byrne C.D., Targher G. NAFLD: A multisystem disease. J. Hepatol. 2015;62(Suppl. 1):S47–S64. doi: 10.1016/j.jhep.2014.12.012. - DOI - PubMed
    1. Musso G., Gambino R., Tabibian J.H., Ekstedt M., Kechagias S., Hamaguchi M., Hultcrantz R., Hagström H., Yoon S.K., Charatcharoenwitthaya P., et al. Association of non-alcoholic fatty liver disease with chronic kidney disease: A systematic review and meta-analysis. PLoS Med. 2014;11:e1001680. doi: 10.1371/journal.pmed.1001680. - DOI - PMC - PubMed

LinkOut - more resources